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[Risk stratification in patients with a first myocardial infarct based on simple clinico-instrumental variables]
A Rosselli1, F Bandini, A Fazi
1II Divisione Medicina, USL 10/C, Ospedale S.M. Annunziata, Firenze.
Insights
Simple clinical factors can help predict cardiovascular risk after a first myocardial infarction. Chronic obstructive lung disease (COLD) is an important factor in assessing patient prognosis.
Area of Science:
- Cardiology
- Pulmonology
Context:
- Prognosis after a first myocardial infarction (MI) is largely determined by residual left ventricle function.
- Assessing cardiovascular risk in post-MI patients requires evaluation of various clinical and instrumental variables.
- Chronic obstructive lung disease (COLD) is a significant comorbidity that may impact MI outcomes.
Purpose:
- To evaluate the importance of simple clinical and instrumental variables in stratifying cardiovascular risk post-MI.
- To emphasize the role of chronic obstructive lung disease (COLD) in predicting outcomes after a first myocardial infarction.
Summary:
- A study included 97 patients with a first MI (no cardiogenic shock or severe comorbidities) treated between 1988-1990.
- Variables assessed included age, sex, family history, diabetes, hypertension, cerebrovascular disease, peripheral artery disease, angina, and COLD.
- Echocardiography, Tc-99 angiocardioscintigraphy, and bicycle ergometer stress tests were performed.
Impact:
- The study aimed to identify key factors for risk stratification in post-MI patients.
- Understanding these factors can lead to more personalized treatment and improved patient management.
- Identifying high-risk patients, including those with COLD, allows for targeted interventions to reduce mortality and reinfarction rates.
Unlabelled:
It is an acknowledged fact that the prognosis for patients with a first myocardial infarction depends mainly on the degree of residual left ventricle function. We wanted to evaluate the importance that certain simple clinical and instrumental variables can have in stratifying post-infarction cardiovascular risk with particular emphasis on chronic obstructive lung disease (COLD). We selected 97 out of the 512 patients treated in the coronary intensive care unit (CICU) from February 1, 1988 to October 31, 1990 according to the following criteria: First myocardial infarction; no cardiogenic shock; no serious concomitant diseases with considered negative prognosis within 6 months. The following variables were considered for all the patients: age; sex; positive family history for ischemic heart disease; history of diabetes mellitus; arterial hypertension; previous cerebrovascular incident; history of obstructive arteriopathy of the lower limbs, of angor and COLD. The following tests were performed on all the patients: echocardiogram prior to discharge form the CICU; angiocardioscintigraphy with Tc-99 between the 20th and 30th day following the acute event; bicycle ergometer stress test on the 30th day.
End Points:
general mortality; cardiac mortality; non-fatal reinfarction; residual angina at 3 months. All the patients were treated with aspirin (325 mg/die) and/or heparin (12,500 units subcutaneously). All 97 patients were monitored for a mean follow-up time of 19.8 months. General mortality was 2.08% (for reinfarction) 24 (24.7%) non-fatal cardiac events.(ABSTRACT TRUNCATED AT 250 WORDS)